Women’s health, men’s health, and gender and health: Implications of intersectionality

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Abstract

Although intersectionality is now recognized in the context of women’s health, men’s health, and gender and health, its full implications for research, policy, and practice have not yet been interrogated. This paper investigates, from an intersectionality perspective, the common struggles within each field to confront the complex interplay of factors that shape health inequities. Drawing on developments within intersectionality scholarship and various sources of research and policy evidence (including examples from the field of HIV/AIDS), the paper demonstrates the methodological feasibility of intersectionality and in particular, the wide-ranging benefits of de-centering gender through intersectional analyses.

Highlights

► Implications of intersectionality have not been fully explored in the context of women’s health, men’s health and gender and health. ► Intersectionality unsettles the fundamental importance of gender (and sex). ► It raises important questions for scholars and researchers concerned with health inequities.

Introduction

Increasingly, health researchers, policy makers, and practitioners concerned with sex and gender are acknowledging the importance of race/ethnicity, class, income, education, ability, age, sexual orientation, immigration status, and geography and are grappling with how to best conceptualize and respond to issues of differences among women and men and how these shape lives and health. As work in this area progresses, intersectionality is being recognized as a valuable normative and research paradigm for furthering understandings of the complexity of heath inequities (Bowleg, 2008, Hankivsky, 2011, Iyer, 2007, Iyer et al., 2008, Schulz and Mullings, 2006, Sen et al., 2009, Weber, 2006). Intersectionality challenges practices that privilege any specific axis of inequality, such as race, class, or gender and emphasizes the potential of varied and fluid configurations of social locations and interacting social processes in the production of inequities. While the fields of women’s health, men’s health, and gender and health have started to explicitly acknowledge and engage with the theoretical and methodological insights of intersectionality, the extent to which current practices align with the tenets of intersectionality is largely uninvestigated. The purpose of this paper is to explore the implications of intersectionality in the context of these fields and to raise important questions for dialogue and debate.

The paper begins with a brief overview of intersectionality, including its relationship to diversity. It then moves to examine core practices within the fields of women’s, men’s, and gender and health. The intent is to show, from an intersectionality perspective, how the treatment and ubiquitous favouring of gender (and sex) as core and primary dimensions of health undermine efforts to understand the complexities of health experiences and outcomes. The paper seeks to bring into sharp relief the resulting mis-specifications of the content of any privileged identity/social location (including but not limited to gender), as well as the masking of health-related experiences of those whose lives are located at the intersection of multiple dimensions of inequity. To illustrate the importance of an intersectionality framework, the paper offers normative and operational guidance for empirical research, examples from emerging intersectionality research, and in particular, evidence from the field of HIV/AIDS. This discussion strives to demonstrate the transformational possibilities of an intersectional analysis but also specifies ongoing gaps and challenges related to applications of intersectionality that require further attention and research development. The paper concludes by considering some of the research, policy, and political consequences of intersectionality for the fields of women’s health, men’s health, and gender and health.

Section snippets

Intersectionality

Originating in the work of African American feminist scholars (Collins, 1990, Crenshaw, 1989, Hooks, 1990), intersectionality “moves beyond single or typically favoured categories of analysis (e.g. sex, gender, race and class) to consider simultaneous interactions between different aspects of social identity…as well as the impact of systems and processes of oppression and domination” (Hankivsky & Cormier, 2009, p. 3). Although there are multiple conceptions of intersectionality, there are also

Women’s health, men’s health, and gender and health

While there are somewhat different approaches that can be identified as women’s health, men’s health, and gender and health, especially in the context of political activism and policy, there are many ways in which they overlap and articulate with one another. Importantly, each prioritizes the dimension of sex/gender above all other axes of social identity and power. From an intersectionality perspective, these practices, which are briefly reviewed below, undermine theoretical and empirical

Elucidating the implications of Intersectionality

Well-rehearsed critiques of an intersectionality perspective include claims that it “does not have any methods associated with it or that it can draw upon” (Phoenix & Pattynama, 2006, p. 189) or that it “does not provide a sufficient foundation for action aimed at improving population health and reducing health disparities” because as an approach that has focused on societal structures it was “not intended to identify points for health intervention” (Bird, Lang, & Reiker, 2010, p. 130). This

Ongoing challenges and gaps

At the same time that intersectionality is making inroads, there continue to be ongoing challenges for intersectionality-informed research and policy. Different versions of intersectionality have different research utility (McCall, 2005, Weldon, 2008). Researchers continue to be challenged by the choices of which social divisions, intersections, or data categories to study and how to best account for within category differences. Intersectionality research to date is often focused on the trinity

Conclusion

Although applications of intersectionality are still developing, emerging research does show that theoretical foundations do influence and direct the way health inequities are conceptualized, studied, and responded to (Krieger et al., 2010). Intersectionality raises critical lines of enquiry. First, it brings to the fore the limitations of research that emphasizes pre-determined classifications (e.g. man and woman) or prioritizes any one single category (e.g. sex or gender) or even a set

Acknowledgments

I would like to thank the Gender and Health Working Group at Columbia University for their insightful feedback on an earlier version of this paper, my editors Lisa Bates and especially Kristen Springer, for their steadfast support and encouragement. I would also like to thank the anonymous reviewers of this article as well as Lynn Weber, Rita Kaur Dhamoon and Ange-Marie Hancock for their comments on earlier drafts of this paper. Thank you to Gemma Hunting for assistance with references. Finally

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